Real angulation degree in fifth metacarpal neck fracture
Bülent A. Taşbaş1, H. Rıfat Özakpınar2, M. Önder Delialioğlu3, Bülent Dağlar1, Kenan Bayrakcı3, Uğur Günel3
1Fatih Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, Ankara, Türkiye;
2Dışkapı Eğitim ve Araştırma Hastanesi 2. Plastik ve Rekonstrüktif Cerrahi Kliniği, Ankara, Türkiye;
3Ankara Numune Eğitim ve Araştırma Hastanesi 4. Ortopedi ve Travmatoloji Kliniği, Ankara, Türkiye;
Keywords: Hand; metacarpal bones; X-ray film.
Objectives: This study investigated whether the confusion about the acceptable angulation value in fifth metacarpal neck fractures results from the hand radiographs taken at nonstandard oblique position. Materials and methods: In this experimental study two Kirshner wires representing the intramedullary axis of the two fracture fragments were placed on a platform prearranged with an angle of 50 degrees between them. The radiographs of the wires were taken on the platform (horizontal) at angles of 0, 30, 45 and 60 degrees. The radiographs were taken without changing the cassette location and the position of the radiography device.
Results: The known volar angulation (50 degrees) was measured on the radiographs as 50, 36, 30 and 23 degrees, respectively.
Conclusion: The main debate about the fifth metacarpal neck fracture is over the acceptable distal fragment volar angulation degree. This degree of angulation is between 30 and 70 degrees in the studies. The presence of such different and inaccurate results in the literature results from the use of non-standard oblique hand radiographs. Standardized radiographs are required in fifth metacarpal neck fractures.